Long-Term Outcome of Neuro-Behçet's Disease

Abstract : : Objective: To report the long-term outcome of neurological involvement in patients with Behçet's disease (BD). Methods: Retrospective analysis of 115 patients fulfilling the international criteria for BD [57% male with median [Q1-Q3] age of 37 [30-46] years] and with neuro-Behçet's disease (NBD) after exclusion of cerebral venous thrombosis. Factors associated with relapse of NBD, dependence and mortality were assessed. Results: Seventy-eight (68%) patients presented with acute NBD and 37 (32%) with a progressive course. The HLA B51 allele was carried by 49% of patients. Overall, 46/115 (40%) patients had a severe baseline disability status, represented by a Rankin score ≥ 3. The 5 and 7 years event-free survival rates were 65% and 53%, respectively. In multivariate analysis, a positive HLA-B51 status was independently associated with the risk of NBD relapse (OR=3.6 [1.5-9.1]). After a median follow-up of 73 [59-102] months, 21 (25.2%) patients became dependent or died. Factors independently associated with poor outcome were paresis at onset (OR=6.47 [1.73-24.23]) and a brainstem location of inflammatory lesions on MRI (OR=8.41 [1.03-68.43]). All 115 patients were treated with glucocorticosteroids, including 53/115 (46.1%) with cyclophosphamide and 40/115 (34.8%) with azathioprine. A trend towards longer event-free survival was observed in severe NBD patients (i.e. Rankin score ≥ 3 at onset) receiving intravenous cyclophosphamide compared with those treated with azathioprine (p =0.06). Conclusion: NBD is a severe condition in which patients with the HLA-B51 allele appear to experience a worse prognosis. © 2013 American College of Rheumatology.
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Arthritis and Rheumatism, Wiley, 2014, pp.1306-1314. 〈10.1002/art.38351〉
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Contributeur : Olivier Colliot <>
Soumis le : mercredi 29 janvier 2014 - 14:49:21
Dernière modification le : jeudi 11 janvier 2018 - 06:25:27

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Nicolas Noel, Remy Bernard, Bertrand Wechsler, Matthieu Resche-Rigon, Raphaël Depaz, et al.. Long-Term Outcome of Neuro-Behçet's Disease. Arthritis and Rheumatism, Wiley, 2014, pp.1306-1314. 〈10.1002/art.38351〉. 〈hal-00938604〉

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